Social Determinants of Accelerated Aging

If you answered yes to all three questions, your telomeres may be shortening at a faster rate than those who answered no (read: are less deprived).

[Note: Telomeres are the ends of chromosomes that get depleted as we age].

At least that’s what a new study coming out of the Glasgow Center for Population Health is reporting. The Public Library of Science recently published the study’s findings, which established that there may be a scientific association between socioeconomic status and aging.

For people with annual incomes lower than £25,000, telomeres showed an average 7.7% decrease in length over a 10-year period. Those with incomes greater than £25,000 showed only a 0.6% shortening in their telomeres in comparison.

Moreover, poor diet was found to exacerbate telomere shortening. Dietary intake was based on participants’ responses on a lifestyle questionnaire. Self-reported frequency of consumption in 21 food categories was used to determine a diet score. Those with poor diets showed a 7.7% decrease in telomere length, compared to 1.8% in those with better diets.

In addition, those renting accommodations compared to those who owned their homes had a telomere length reduction of 8.7% compared to 2.2%, respectively.

This study is interesting because it offers scientific evidence for health inequities while proposing that a combination of factors affecting an individual's livelihood may indeed determine how quickly he or she ages.

Results from this study and those that may follow would potentially be useful in informing public health initiatives that address health disparities among poor older adults.

As a caveat, although these results could be useful at a population level, they are not applicable in determining individual life expectancy.

By: Julie N. Thai [GeriPal International Correspondent]

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Fascinating study. Perhaps it provides a novel mechanism for a fundamental observation about health that has been known for several centuries: Persons who have poor socioeconomic status (SES) have much worse health outcomes than persons with good (SES).

The relationship between SES and health is so strong that in some studies SES better predicts death and disabity better than the presence of disease.

This observation is of more than theoretical interest. The failure to account for SES causes many research designs to give us the wrong answer.

For example, many believe failure to account for SES is the reason why so many women were put on estrogen replacement therapy, even though it was later shown to be harmful.

Early studies showed women who took estrogen suffered less heart disease than women who did not take estrogen. It was assumed that this was because estrogen therapy was protective.

But, later randomized studies showed just the opposite. Estrogen actually increased rates of heart disease. One reason estrogen may have appeared beneficial in early studies was because women who took estrogen had better SES.

One way to look at this: The protective effect of high SES is so powerful that richer persons may still do better than poorer persons even when the richer persons are given a harmful treatment.

The bottom line--all observational research studies should measure SES and control for it. For example, if we are looking at whether persons who take vitamin e have a lower risk of cancer than those who don't take vitamin e, we should make sure any difference in SES between vitamin users and nonusers is accouted for. If we are looking at whether biologic measures, such as measures of inflammation are associated with heart disease, we should make sure SES is not associated with the biologic measure.

The need to account for SES as a determinant of health is so clear that one would surely think that most medical studies do so. But in fact, very very few studies account for SES.

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